Eck Institute for Global Health to study Zika in Belize

The University of Notre Dame has announced a collaboration with Mayo Clinic, the Belize Ministry of Health and the Belize Vector and Ecology Center aimed at strengthening the country’s ability to respond to Zika virus and other arboviruses. Researchers are already working in Belize as part of the five-year project, which will include a full epidemiological and entomological surveillance study, training for health care professionals and public health awareness and education.

John Grieco and Nicole Achee, research associate professors with the Eck Institute for Global Health, will lead vector surveillance activities. From Mayo Clinic, John Wilson, in the Division of Infectious Diseases, and Elitza Theel, in the Division of Clinical Microbiology, will lead activities associated with capacity building for diagnostic testing of arboviral diseases. They will also spearhead the human epidemiological studies for Zika and other arboviruses in Belize.

Just how widely Zika has spread in Belize is unknown, and Grieco said that is precisely why this project is so vital to the country’s future.

“This will put Belize on the front line of determining what’s going on in its country,” said Grieco, who also serves as associate director of the Eck Institute for Global Health. “As in many areas of Central and South America, the Zika situation in Belize is not well-defined. The symptoms of Zika can present in the same way as many other illnesses in these settings, resulting in cases going underreported.”

The initiative is aimed at strengthening the diagnostic capabilities of Belize to accurately and efficiently identify Zika cases. The information, along with the epidemiological and educational components, will provide valuable insight into the transmission of Zika and other arboviruses such as dengue and chikungunya.

The current strategy follows that any suspected cases of Zika or other arboviruses are immediately reported to the local vector control office. While in-country health professionals are equipped to administer initial tests, samples are sent out of the country for confirmation and identification of the virus. This can be costly and result in extensive delays.

“Samples must be shipped on ice, which further complicates the number of samples that can be shipped at any one time,” Grieco said. “So, if you have a country where an epidemic is brewing and you’re getting thousands of cases a week, the system is overwhelmed. The local health agencies have to pick and choose what they’re going to test.”

Meanwhile, vector control officers will spray the patient’s home, along with a surrounding perimeter, with insecticide as a protective barrier. Doing so without a timely and accurate confirmation of the virus can be a waste of limited resources and staff.

Notre Dame and Mayo Clinic will provide additional education and training of health professionals and public health officers within local communities to help them understand the different aspects of the disease and diagnostic testing options.

Grieco and Achee in collaboration with the Belize Vector and Ecology Center will conduct a countrywide surveillance of the Aedes aegypti mosquito, known to carry the virus, in the country. Surveillance will include mapping locations of confirmed cases and positive mosquito pools as well as analysis of transmission dynamics. Alongside these efforts, Theel and Wilson will work with laboratory technologists in the Belizean Central Medical Laboratory to train and implement serologic tests for both the Zika and chikungunya virus. Simultaneously, studies to determine the rate of infection with these mosquito-borne viruses in Belize will be performed using residual blood samples collected from Belizean blood donors.